The arteriovenous fistula (AVF) is the choice made of access to the circulation in patients having chronic hemodialysis. AVFs are also used in patients having repeated courses of intravenous chemotherapy. This relatively simple operation can result in considerable morbidity if improperly done. The technics used in our center, which result in a high patency rate, are described. Maneuvers designed to reduce the resistance to flow and increase the minute flow through the fistulas are stressed.